Future Harm Research Articles

The Future Harm Exception: Coercive Control as Serious Psychological Harm and the Challenge for Lawyers' Ethics

Can a lawyer use the future harm exception to prevent her client from coercively controlling his former spouse? Lawyers are required to keep their clients’ secrets unless an exception applies. One of those exceptions is where there is a clear and imminent risk of serious bodily harm or death to an identifiable group or person. The exception provides that serious psychological harm constitutes serious bodily harm, but there is very little guidance as to what type of threat might meet the test. Coercive control is a type of family violence whereby an abusive spouse will use a pattern of tactics designed to control his partner. In this paper, I argue that the psychological harm caused by coercive control meets the test for the future harm exception. An abuser’s lawyer can use the exception to try to prevent psychological harm to her client’s former spouse. However, this idea creates tension with the lawyer’s duty of loyalty, and the test itself is challenging in the context of coercive control. In this paper, I provide three recommendations for amendments to the Model Code of Professional Conduct, which would start to make the Code responsive to coercive control; but to be truly responsive, real change needs to be made to the justice system and the lawyer’s role itself.

Medical Error, Adverse Events, and Complications in Interventional Radiology: Liability or Opportunity?

This review suggests that there is a critical need to renew understanding of adverse events and complications within interventional radiology and to redefine a robust commitment to patient safety a...

The Responsibility to Prevent Future Harm

Through the example of legal resistance to mining in Ecuador, this article explores the shift towards suing states rather than corporations. Key to ongoing resistance struggles is the allocation of preventive responsibility to ‘the state’ through the filing of constitutional lawsuits. I show how both the shift from the ‘politics of space’ to a ‘politics of time’ and a shift in the imaginary of the state contribute to claims of responsibility being increasingly directed at states. The article inquires into the effects of the temporal reversal from assessing past harm (and ruling retrospectively) to assessing the likelihood of future scenarios in order to prevent future harm. Finally, I address the limits of such allocation of responsibility, showing that while constitutional lawsuits are political attempts to challenge the government’s economic programme and disrupt the logic of global capitalism, many powerful policy-shaping actors remain beyond the law’s reach.

Ethics analysis of light and vitamin D therapies for seasonal affective disorder.

The aim of this ethics analysis was to highlight the overt and covert value issues with regard to two health technologies (light therapy and vitamin D therapy), the health technology assessment (HTA) and the disease of seasonal affective disorder (SAD). The present ethics analysis served as a chapter of a full HTA report that aimed to assist decision makers concerning the two technologies. First, we used the revised Socratic approach of Hofmann et al. to build overarching topics of ethical issues, and then, we conducted a hand search and a comprehensive systematic literature search on between 12 and 14 February 2019 in seven databases. The concrete ethical issues found concerned vulnerability of the target population and the imperative to treat depressive symptoms for the sake of preventing future harm. Further disease-related ethical issues concerned the questionable nature of SAD as a disease, autonomy, authenticity, and capacity for decision making of SAD patients, and the potential stigma related to the underdiagnosis of SAD, which is contrasted with the concern over unnecessary medicalization. Regarding the interventions and comparators, the ethical issues found concerned their benefit-harm ratios and the question of social inequality. The ethical issues related to the assessment process relate to the choice of comparators and the input data for the selected health economic studies. The concrete ethical issues related to the interventions, the disease, and the assessment process itself were made overt in this ethics analysis. The ethics analysis provided an (additional) value context for making future decisions regarding light and vitamin D therapies.

Climate Change and the Free Marketplace of Ideas?

Climate change poses a significant danger that requires intervention today; climate denial poses a key challenge to meaningful timely intervention. In this paper, we argue that current free speech jurisprudence in the US inadequately addresses the risk of climate change because it is overly permissive of ‘professional’ climate denial and underappreciates the need to address the future harm of climate change today. We begin by clarifying the risk posed by the Supreme Court's current approach to speech with respect to climate change and, relatedly, reviewing the philosophical foundations of the marketplace of ideas found in the work of John Stuart Mill. Following this, we examine three potential ways in which Supreme Court jurisprudence could be used to limit what we term ‘professional climate change denial’ while permitting a degree of ‘private’ scepticism. Largely setting aside the return to earlier free speech jurisprudence and the extension of libel law, we offer a novel solution to the problem that suggests that ‘professional’ climate denial could be treated as a categorical exception under free speech jurisprudence and thus afforded a lower level of constitutional protection than other expression.

Rethinking Thomas Hobbes on the Passions

AbstractThere is widespread scholarly disagreement whether Hobbesian passions are or involve a type of cognition (i.e., imagination). This largely overlooked disagreement has implications for our understanding of Hobbesian deliberation. If passions are intrinsically cognitive, then, because Hobbesian deliberation is a series of alternating passions, deliberation would appear to be intrinsically cognitive as well. In this paper, I bring to light this overlooked disagreement and argue for a non‐cognitive reading of Hobbesian passions, according to which, a passion is an appetite or aversion caused by, but distinct from, an imagination of a future good or harm.

Future proofing the principle of no significant harm

The principle of ‘no significant harm’ as a way of addressing transboundary environmental challenges is both inadequately researched and inadequately implemented in many parts of the world. This paper addresses the questions: What is the nature of transboundary harm in the Anthropocene? Is the principle of no significant harm able to address current and pre-empt future transboundary harm in the field of water and environmental law? This special issue has focused on this principle in the arena of water law. This article integrates the findings in the context of a broader understanding of global harm in the Anthropocene. We draw 4 conclusions. First, conceptually harm is moving beyond direct inter-state harm between neighbouring countries to a multi-directional, multi-actor/multi-level harm, which is increasingly creeping and cumulative, with growing spatial and temporal characteristics. It thus requires moving beyond quibbling over what is ‘significant’ harm to recognize the climate emergency, the sixth biodiversity extinction, the huge damage to water systems and to realize that the threshold of ecosystem and human tolerance of damage are reducing rapidly. Second, however, the no-harm principle tends to be better developed in qualifying sovereignty in relation to transboundary harm on rivers than in the broader environmental and development arena as demonstrated by agenda 2030 which reverts to full permanent sovereignty. Third, legal scholarship, however, does provide a wide range of instruments for addressing harm before it occurs, after it has happened, and considering the differentiated economic capacity of the actors. Finally, the larger problem is that it is not individual projects or programmes that cause problems as much as national prioritization of economic growth which has led to externalizing the environment. The no-harm principle will be ineffective if it cannot be used to question the content of ‘growth’-led policies. There is need to future proof the no-harm principle.

Breaking the Silent Treatment


 
 
 The dramatic revelations of the #MeToo movement have ex- posed the extent to which workplace sexual harassment is en- demic and concealed across different industries. #MeToo has also shed light on the use of non-disclosure agreements (“NDAs”) by harassers to conceal their pattern of repeated mis- conduct. While there has been strong public condemnation of NDAs in the wake of the #MeToo movement, there is limited case law on the question of whether contracts such as NDAs are legally enforceable when used to settle claims of sexual har- assment that do not amount to criminal conduct.
 While federal and state legislatures continue to debate the benefits of legislating against such agreements, this Note ana- lyzes the viability of the common law public policy analysis to hold such NDAs unenforceable. Given that most states do not have specific statutes directly addressing sexual harassment NDAs, courts should look to a broad range of state legislation as relevant in considering the public policy interests counseling toward finding such NDAs unenforceable. Accordingly, this Note analyzes public policy considerations derived from three types of state law: restrictions on the use of NDAs in instances of sexual harassment, prohibitions of workplace harassment, and limitations on the concealment of public hazards.
 
 
 
 Even in states without any such legislation, this Note urges state courts, when determining whether to enforce sexual har- assment NDAs, to more actively weigh the benefits of enforcing the contractual will of private parties against potential harms to the public welfare. Workplace sexual harassment is a public policy issue that is worsened by the continued use of NDAs. In concealing workplace sexual misconduct, NDAs prevent soci- ety, through private and state actors, from addressing the problem itself and threaten public safety and welfare by allow- ing offenders to potentially harm future workers. Without NDAs as protection, companies will be exposed to reputational damage and potential shareholder litigation when sexual har- assment news becomes public knowledge. Indeed, this threat of future reputational harm could be an effective way to encour- age corporations to change their internal policies relating to workplace misconduct.
 
 
 
 
 

‘It's a tradition to go down to the pokies on your 18th birthday’ – the normalisation of gambling for young women in Australia

ObjectiveTo understand the range of factors that may influence the normalisation of gambling for young women in Victoria, Australia. MethodsIn‐depth qualitative telephone interviews with 45 women aged 18–34 years. ResultsYoung women were exposed to gambling environments and some were gambling from an early age. Family members were the key facilitators of these activities. Once reaching the legal age of gambling, peers and boyfriends were instrumental in young women's gambling practices. Women attributed the normalisation of gambling to excessive marketing, feminised gambling environments, and the widespread availability of gambling in the community. ConclusionsThis study found several factors that influenced and encouraged young women to gamble, such as the feminisation of gambling products and environments, and determined that gambling is becoming a socio‐culturally accepted activity for young women. Implications for public healthResearchers and policymakers should be increasingly focused on how different forms of gambling may be normalised for young women. Attention should be given to how young women may become a target market for the gambling industry, and how to implement strategies aimed at preventing any future potential harm posed by these industries and their marketing tactics and products.

Lessons from the triennial analysis of serious case reviews

Abstract Serious Case Reviews (SCRs) provide an important opportunity for professional learning when children have died or suffered serious harm from abuse or neglect. The triennial SCR analysis seeks to identify themes across SCRs to inform practice and guide the development of new strategies in order to prevent future harm to children. Neglect is a key feature of most serious case reviews; it is a complex issue with multiple contributory factors accumulating over time. Neglect is linked with unfavourable outcomes at individual and societal levels. Many of the families concerned are living in poverty and difficulties are exacerbated by the limitation of resources with which to support them. This article considers key messages for paediatric practice from the 2014–17 triennial review, particularly with respect to neglect and adolescent safeguarding concerns.

Women’s stories of non-fatal strangulation: Informing the criminal justice response

Non-fatal strangulation is commonly reported by women who have experienced intimate partner violence and it has been identified as both an immediate risk to health and life but also a risk for future serious harm and even death. While some Australian states and Canada have followed the lead of American states in introducing criminal offences of non-fatal strangulation the United Kingdom is yet to do so. Non-fatal strangulation offences have come with challenges of definition and identification. The success of criminal justice responses requires an understanding of the ways in which women understand and describe their non-fatal strangulation victimisation. We analyse 24 women’s experiences of non-fatal strangulation as a basis for considering how to ensure that jurisdictions considering introduction of a new non-fatal strangulation offence or reform of an existing offence do not reproduce obstacles to prosecution and legal recognition and suggest a model definition of non-fatal strangulation for an offence.

The clinical and educational outcomes of an inter-professional student-led medication review team, a pilot study

AimsThe involvement of an inter-professional healthcare student team in the review of medications used by geriatric patients could not only provide patients with optimized therapy but also provide students with a valuable inter-professional learning experience. We describe and evaluate the clinical and learning outcomes of an inter-professional student-run mediation review program (ISP).Subject and methodA variable team consisting of students in medicine, pharmacy, master advanced nursing practice, and master physician assistant reviewed the medication lists of patients attending a specialized geriatric outpatient clinic.ResultsDuring 32 outpatient visits, 188 medications were reviewed. The students identified 14 medication-related problems, of which 4 were not recognized by healthcare professionals. The ISP team advised 95 medication changes, of which 68 (71.6%) were directly implemented. Students evaluated this pilot program positively and considered it educational (median score 4 out of 5) and thought it would contribute to their future inter-professional relationships.ConclusionAn inter-professional team of healthcare students is an innovative healthcare improvement for (academic) hospitals to increase medication safety. Most formulated advices were directly incorporated in daily practice and could prevent future medication-related harm. The ISP also offers students a first opportunity to work in an inter-professional manner and get insight into the perspectives and qualities of their future colleagues.

Certain Problems of Citizens’ Rights Protection when Using Genomic Technologies

In the context of the rapid development of new medical technologies, the problem of protecting the rights of citizens and ensuring respect for human dignity is becoming increasingly urgent. The authors come to the conclusion that the protection of the patient’s rights when using genomic technologies can be carried out in the order of claim proceedings. Typical methods of protection are recovery of damages in the event of injury to health, compensation for moral damage in connection with the violation of such non-material benefits as life, health, physical integrity, privacy. Particular attention is given to the problem of children’s rights protection when using genomic technologies, including the right to natural biological origin, the right to know their biological parents and family (genetic) history, since the use of advances in genetics and biomedicine by one generation of people can be a serious challenge to the existence of fundamental freedoms and equality of future generations.At the moment, states should define the limits of possible intervention in the sphere of private (parental) arbitrariness in order to prevent future harm to children born with the help of modern technologies. Consideration of individual problems of the rights of citizens protection when using genomic technologies indicates objective difficulties in finding solutions due to bioethical principles, the need to ensure a fair balance between the interests of the parties to the relevant relationship and third parties, and the need to minimize potential risks. The breakthrough achievements of medical and biological science pose an important task for the state to develop an effective system of legal guarantees aimed at ensuring respect for human dignity, protecting the rights and interests of an individual, preventing the biotechnological construction of a person for the purposes of eugenic practice, etc.

Alcohol consumption at selected bars in Keffi, Nigeria: Consumers’ awareness of recommended limits and consumption motivations

Are alcohol consumers aware of the recommended limit of alcohol consumption per day? What are the motivations for alcohol consumption? These questions constitute the major objective of this study. The study was carried out in Keffi town in Nasarawa State, Nigeria. Exploratory research design was adopted while the qualitative research method and instrument were adopted for data collection. Semi-structured interviews were conducted with 52 alcohol consumers in two different bars in Keffi. The study found that while all consumers expressed various reasons for alcohol consumption, all the interviewed respondents were not aware of the quantity of alcohol that poses immediate or future harm to the consumer. Consequently, all the interviewed drinkers consumed above the WHO recommended percentage of alcohol consumption per day. The study recommends that alcoholic drinks, and advertisements should carry more information about recommended daily intake, and quantity of alcohol that poses health and safety risks.

Prefrontal Cortex Representation of Learning of Punishment Probability During Reward-Motivated Actions.

Actions executed toward obtaining a reward are frequently associated with the probability of harm occurring during action execution. Learning this probability allows for appropriate computation of future harm to guide action selection. Impaired learning of this probability may be critical for the pathogenesis of anxiety or reckless and impulsive behavior. Here we designed a task for punishment probability learning during reward-guided actions to begin to understand the neuronal basis of this form of learning, and the biological or environmental variables that influence action selection after learning. Male and female Long-Evans rats were trained in a seek-take behavioral paradigm where the seek action was associated with varying probability of punishment. The take action remained safe and was followed by reward delivery. Learning was evident as subjects selectively adapted seek action behavior as a function of punishment probability. Recording of neural activity in the mPFC during learning revealed changes in phasic mPFC neuronal activity during risky-seek actions but not during the safe take actions or reward delivery, revealing that this region is involved in learning of probabilistic punishment. After learning, the variables that influenced behavior included reinforcer and punisher value, pretreatment with the anxiolytic diazepam, and biological sex. In particular, females were more sensitive to probabilistic punishment than males. These data demonstrate that flexible encoding of risky actions by mPFC is involved in probabilistic punishment learning and provide a novel behavioral approach for studying the pathogenesis of anxiety and impulsivity with inclusion of sex as a biological variable.SIGNIFICANCE STATEMENT Actions we choose to execute toward obtaining a reward are often associated with the probability of harm occurring. Impaired learning of this probability may be critical for the pathogenesis of anxiety or reckless behavior and impulsivity. We developed a behavioral model to assess this mode of learning. This procedure allowed us to determine biological and environmental factors that influence the resistance of reward seeking to probabilistic punishment and to identify the mPFC as a region that flexibly adapts its response to risky actions as contingencies are learned.

Fear, Anxiety and Health-Related Consequences After the Covid-19 Epidemic.

The current COVID-19 pandemic is causing direct and indirect effects in the global population. In this paper, fear and its possible forthcoming consequences on health will be investigated and discussed. Fear is an innate reactive emotion to the immediate threats produced by danger. It is hardwired within subcortical survival circuits and originally had to defend the organism from predators. Besides, fear is a cognitive emotional process mediated by the cortical structures, and implies a subjective evaluation both at implicit (subsymbolic, unconscious) and explicit (symbolic, conscious) levels. Within a defensive taxonomy framework, fear can be defined as a reflex triggering a prompt behavior aimed at surviving from predating attacks (freezing), whereas anxiety as a deliberate pattern aimed at planning behaviors for anticipating and avoiding future harm. Fear and anxiety overlap at a subjective level, but are generated by different neurobiological networks and serve different evolutionary goals. The current viral danger and the need for social distancing worsen the sense of loneliness. A wide body of experimental and epidemiological literature evidence that psychological stress, social isolation, and loneliness have a detrimental effect on multiple health-related outcomes including comorbidity, multimorbidity, and mortality. The negative effects can be even higher for people currently living a massive limitation of physical and interpersonal contacts. A strong effort to integrate psychological and medical care is needed to face post-pandemic health issues.

Addressing Sexual Harassment Law’s Inadequacies in Altering Behaviour and Preventing Harm: A Structural Approach

Section 3(c) of the Sex Discrimination Act 1984 (Cth) provides that one object of the Act is ‘to eliminate, so far as is possible, discrimination involving sexual harassment in the workplace, in educational organisations and in other areas of public activity’. This article argues that the Act, in its current form, is not adequate for achieving that object for two reasons: first, its operative provisions reflect a normative principle that has, as its aim, the compensation of harm but not the prevention of future harm; and second, it fails to recognise some systemic harms caused by sexual harassment. The article proposes a structural approach to workplace sexual harassment regulation, which involves a positive duty for organisations to take reasonable steps to prevent sexual harassment and a regulatory framework aimed at putting in place the necessary motivations and incentives to ensure compliance with that duty. The article draws on insights from regulatory theory to explain how this regulatory approach can better serve the object of eliminating sexual harassment so far as is possible.

A new tool for identifying risk of repeated intimate partner violence adjusted for the population of Montenegro: a cohort study.

Current estimates suggest that approximately 20% of women and 11% of men have been victims of intimate partner violence. Risk identification tools for repeated domestic violence currently exist and have typically been designed by police and judicial authorities, based on the criminal history of the perpetrator. A follow-up cohort study of 238 cases of intimate partner violence (judicially processed and officially judged as DV according to Montenegrin Criminal Act) was conducted by reviewing randomly selected court files. The results showed that certain perpetrator characteristics (unemployment, lack of regret, other violent criminal history, and history of being beaten by a family member) and victim characteristics (nonqualified education and predictions of future harm) were associated with reassault. Relationship characteristics such as different ethnicity, poor socioeconomic status, difference in incomes, living in a rental property, alcohol and drug use, and unprocessed previous history of physical violence were also associated with repeated violence. A risk identification tool for repeated intimate violence was computed based on the significant variables, with a sensitivity of 85% and a specificity of 89%. This study demonstrates a new tool for repeated intimate partner violence prediction in patriarchal societies, widespread in Eastern Europe and the Middle East. The majority of factors associated with reassault in this sample have been shown to be predictive for repeated intimate partner violence in previous studies. The applicability of our tool in egalitarian societies should be investigated in order to see whether the combination of these factors is universal or specific to patriarchal societies.

Weaponized Noncombatants, Child Soldiers, and Targeting Innocents

ABSTRACT This article presents a novel theory of noncombatant immunity that can serve as a practical guide for soldiers in the field. It improves on existing theories by justifying why and when an innocent target may be attacked, and (more importantly) when that same target may no longer be. The theory builds on the claim that “self-defense” is a special case of “war,” not the other way around. Self-defense requires an immediate threat, where violence in war requires only the prediction of a future threat; thus, targets in war may be attacked (regardless of individual innocence) if they pose a predictable threat of future harm. A morally innocent person can nevertheless pose such a threat if part of a coercive social structure that poses a threat, such as a conscript army or munitions factory manned by slaves; conversely, an innocent person that is broken free of such a coercive structure, and no longer poses a threat, ceases to be a licit target regardless of military necessity.

The Temporality of Disaster: Data, the Emergency, and Climate Change

Climate change threatens to destabilise existing humanitarian temporalities, particularly the idea of ‘building back better’. Building back better, which involves reducing vulnerability to future harm, depends on our being able to predict, to at least some extent, what the future will be like. Climate change, destabilises our predictive abilities and thus limits our ability to adequately respond to future risk. In response, there is an increased humanitarian emphasis on resilience, adaptive capacity, and self-survival. At the same time, the data tools used by humanitarian actors to manage environmental risk focus attention on the present moment, rather than understanding the historical drivers of risk or invigorating new imaginings of the future. Thus climate change and humanitarian digital data tools reinforce a focus on an always unfolding present with implications for ways we might reimagine the future. If humanitarians involved in disaster recovery want to be more than emergency technicians in a world of worsening and increasing need, they have to reimagine the world, their role in it, and the temporal resister(s) with which they engage.